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Li Z, Zhou Y, Tan Y, Zhu X, Liu W, Chen Y, Qin Y, Li R, Yu L, Zhao R, Xu Y. Development and Validation of Nutrition Literacy Assessment Instrument for Chinese Lactating Women: A Preliminary Study. Nutrients 2023; 15:3488. [PMID: 37571425 PMCID: PMC10421061 DOI: 10.3390/nu15153488] [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: 07/03/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
This study focused on the development and validation of a nutrition literacy assessment instrument for Chinese lactating women (NLAI-L). A comprehensive literature review and group discussion by experts in relevant fields were adopted to determine the dimension, topics and questions of NLAI-L. Content validity was evaluated by a panel of experts. The exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were used to evaluate the construct validity. Cronbach's α and split-half reliability were applied to examine the reliability of NLAI-L. The final NLAI-L consisted of 38 questions covering three dimensions: knowledge, behavior and skill. The EFA revealed four sub-domains for knowledge, one sub-domain for behavior and four sub-domains for skill. The results showed that NLAI-L had satisfactory content validity (CVI = 0.98, CVR = 0.96), good reliability (Cronbach's α coefficient = 0.84) and acceptable construct validity (χ2/df = 2.28, GFI = 2.81, AGFI = 0.79, RMSEA = 0.057). In the application part, the average NL score was 46.0 ± 9.3. In multivariate linear regression, education level, age, postnatal period and occupation were the potential influencing factors of NL for Chinese lactating women. The study established an effective and reliable assessment instrument for Chinese lactating women (NLAI-L) through qualitative and quantitative methods. The establishment of NLAI-L will provide an effective tool for exploring the role of NL in health or disease and provide a basis for the formulation of targeted nutrition interventions.
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Affiliation(s)
- Zhao Li
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yalin Zhou
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yuwei Tan
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Xiaoyu Zhu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Wei Liu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yuhan Chen
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yong Qin
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Ruijun Li
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Lanlan Yu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Runlong Zhao
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
| | - Yajun Xu
- School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing 100083, China; (Z.L.); (Y.Z.); (Y.T.); (X.Z.); (W.L.); (Y.C.); (Y.Q.); (R.L.); (L.Y.); (R.Z.)
- Beijing Key Laboratory of Toxicological Research and Risk Assessment for Food Safety, Peking University, No. 38 Xueyuan Road, Beijing 100083, China
- PKUHSC—China Feihe Joint Research Institute of Nutrition and Healthy Lifespan Development, No. 38 Xueyuan Road, Beijing 100083, China
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Chattaraman V, Lee YM, Robinson EM, Book AJ, Al-Amin F. The Effects of Social Distance and Front-of-Package Claims on Healthy Food Selection: Moderating Role of Perceived Importance of Eating Healthily. Nutrients 2023; 15:3427. [PMID: 37571366 PMCID: PMC10420879 DOI: 10.3390/nu15153427] [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: 06/30/2023] [Revised: 07/27/2023] [Accepted: 07/30/2023] [Indexed: 08/13/2023] Open
Abstract
Applying construal level theory, this study examined how social distance (thinking of self/children), front-of-package (FOP) claim type (nutrient/health/control), and perceived importance of eating healthily (low/high) impact consumer responses (attitudes/purchase intent) to healthier food products through an online experiment with 171 U.S. parents from low-to-mid socio-economic households. Participants were randomly assigned to view controlled images of healthier foods with packaging that bore different claim types for real and fictitious brands. Results revealed that when choosing for themselves, consumer attitudes were more positive when the healthier food package carried a nutrient (vs. health) claim, however, control claims received the most positive evaluations. When choosing for children, attitudes were more positive when the package carried a health (vs. nutrient/control) claim. Attitudes toward healthier foods were higher for consumers with high (vs. low) perceived importance of eating healthily when the package bore a nutrient claim, however, their attitudes did not significantly differ when the package bore a health/control claim. Purchase intent for healthier foods was higher for consumers with high (vs. low) perceived importance of healthy eating when shopping for self; whereas, when shopping for children, purchase intent did not significantly differ between consumers who varied in perceived importance of eating healthily.
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Affiliation(s)
- Veena Chattaraman
- Department of Consumer and Design Sciences, Auburn University, Auburn, AL 36849, USA; (A.J.B.); (F.A.-A.)
| | - Yee Ming Lee
- Horst Schulze School of Hospitality, Auburn University, Auburn, AL 36849, USA;
| | - Ebony Marchelle Robinson
- Department of Human Development and Consumer Sciences, University of Houston, Houston, TX 77204, USA;
| | - Adam J. Book
- Department of Consumer and Design Sciences, Auburn University, Auburn, AL 36849, USA; (A.J.B.); (F.A.-A.)
| | - Fnu Al-Amin
- Department of Consumer and Design Sciences, Auburn University, Auburn, AL 36849, USA; (A.J.B.); (F.A.-A.)
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Gao T, Duan Y, Qi Q, Mo G, Han S, Liu H, Zhang M. Nutrition literacy differs based on demographics among University students in Bengbu, China. Front Public Health 2023; 11:1113211. [PMID: 36935682 PMCID: PMC10020653 DOI: 10.3389/fpubh.2023.1113211] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Background Nutrition literacy (NL) encompasses the knowledge and skills that inform individuals' food choices. This cross-sectional study explored factors associated with NL among Chinese university students in Bengbu, China. Methods A cross-sectional survey was carried out. Two thousand one hundred thirty-three university students were selected by stratified cluster sampling. A 43-item NL questionnaire was used to assess NL. Binary logistic regression was used to determine odds ratios (ORs) along with 95% confidence intervals (CIs) for NL and to test the interaction effects of multiple factors on total NL and its six dimensions. Results Of these participants, 1,399 (65.6%) were women and 734 (34.4%) were men. Students who were from urban areas (OR = 1.36, 95% CI: 1.08-1.72), were living with both parents (OR = 1.30, 95% CI: 1.02-1.65), and had high academic performance (OR = 1.85, 95% CI: 1.34-2.57) were more likely to report higher NL levels than did other students. The ORs for NL (OR = 1.60, 95% CI: 1.06-2.41), nutrition knowledge (OR = 1.51, 95% CI: 1.00-2.26), obtaining skills (OR = 1.76, 95% CI: 1.16-2.65), and critical skills (OR = 1.59, 95% CI: 1.05-2.39) were higher for medical students who had received nutrition education than for other students. The ORs for NL (OR = 2.42, 95% CI: 1.21-4.84), nutrition understanding (OR = 2.59, 95% CI: 1.28-5.25), and interactive skills (OR = 2.06, 95% CI: 1.04-4.08) were higher for only-child students and those with a monthly expenditure of >¥1500. Conclusions NL of university students differed in terms of place of origin, living arrangement, nutrition education, academic performance, and household income, and the findings imply that universities should have all students take a basic nutrition course to improve their NL.
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Affiliation(s)
- Tianjing Gao
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Ying Duan
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Qi Qi
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Guangju Mo
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Siyue Han
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, Bengbu, Anhui, China
- *Correspondence: Huaqing Liu
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, Anhui, China
- Min Zhang
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Sneij A, Farkas GJ, Carino Mason MR, Gater DR. Nutrition Education to Reduce Metabolic Dysfunction for Spinal Cord Injury: A Module-Based Nutrition Education Guide for Healthcare Providers and Consumers. J Pers Med 2022; 12:2029. [PMID: 36556250 PMCID: PMC9786330 DOI: 10.3390/jpm12122029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
Spinal cord injury (SCI) results in a high prevalence of neurogenic obesity and metabolic dysfunction. The increased risk for neurogenic obesity and metabolic dysfunction is mainly due to the loss of energy balance because of significantly reduced energy expenditure following SCI. Consequently, excessive energy intake (positive energy balance) leads to adipose tissue accumulation at a rapid rate, resulting in neurogenic obesity, systemic inflammation, and metabolic dysfunction. The purpose of this article is to review the existing literature on nutrition, dietary intake, and nutrition education in persons with SCI as it relates to metabolic dysfunction. The review will highlight the poor dietary intakes of persons with SCI according to authoritative guidelines and the need for nutrition education for health care professionals and consumers. Nutrition education topics are presented in a module-based format with supporting literature. The authors emphasize the role of a diet consisting of low-energy, nutrient-dense, anti-inflammatory foods consistent with the Dietary Guidelines for Americans' MyPlate to effectively achieve energy balance and reduce the risk for neurogenic obesity and metabolic dysfunction in individuals with SCI.
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Affiliation(s)
- Alicia Sneij
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
| | - Gary J. Farkas
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
| | - Marisa Renee Carino Mason
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
| | - David R. Gater
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- South Florida Spinal Cord Injury Model System, University of Miami Miller School of Medicine, Miami, FL 33101, USA
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Hemmer A, Hitchcock K, Lim YS, Butsch Kovacic M, Lee SY. Development of Food Literacy Assessment Tool Targeting Adults With Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:966-976. [PMID: 34426065 PMCID: PMC8922242 DOI: 10.1016/j.jneb.2021.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 05/18/2021] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Develop and test validity and reliability of the Food Literacy Assessment Tool (FLitT) in adults with low income. DESIGN Face validity was tested using cognitive interviews, content validity using expert review, and internal consistency reliability and test-retest reliability based on 2 administrations of the survey. SETTING Urban choice food pantry in Cincinnati, OH. PARTICIPANTS There were 10 and 98 adults with low income for the cognitive interview and survey, respectively VARIABLES MEASURED: Knowledge, self-efficacy, and behavior required to plan and manage, select, prepare, and eat in relation to food. ANALYSIS Cronbach α and Kuder-Richardson Formula 20 for internal consistency reliability and intraclass correlation coefficient (ICC) for test-retest reliability. RESULTS Cognitive interviews and expert feedback suggested modifications to improve the clarity of FLitT and offer more response options. Testing shows acceptable internal consistency in self-efficacy (Cronbach α = 0.92) and behavior (Cronbach α = 0.90) but not in knowledge (Kuder-Richardson Formula 20 = 0.51). The FLitT shows acceptable test-retest reliability for knowledge (ICC = 0.84), self-efficacy (ICC = 0.70), and behavior (ICC = 0.93). CONCLUSIONS AND IMPLICATIONS The FLitT was developed and tested for face and content validity and internal and test-retest reliability in adults with low income. Additional research is needed to conduct a second round of face validity and test construct validity using factor analysis with a larger size.
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Affiliation(s)
- Audrey Hemmer
- Nutrition Therapy Department, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kathryn Hitchcock
- Nutrition Therapy Department, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Youn Seon Lim
- Quantitative and Mixed Methods Research Methodologies, Educational Studies, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH
| | - Melinda Butsch Kovacic
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH; Division of Asthma Research, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Seung-Yeon Lee
- Department of Rehabilitation, Exercise, and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH.
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Vettori V, Lorini C, Gibbs HD, Sofi F, Lastrucci V, Sartor G, Fulvi I, Giorgetti D, Cavallo G, Bonaccorsi G. The Nutrition Literacy Assessment Instrument for Italian Subjects, NLit-IT: Exploring Validity and Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073562. [PMID: 33808072 PMCID: PMC8036908 DOI: 10.3390/ijerph18073562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
The aim of this study was to test validity and reliability of the adapted version of the Nutrition Literacy Assessment Instrument (NLit) for Italian people (NLit-IT). An observational cross-sectional study was conducted, involving a convenience sample of adults (n = 74). To explore the validity of the tool, we considered both diet quality as an outcome of NL, and health literacy (HL) as a construct that presents similarities and differences with NL. Diet quality was measured by adherence to the Mediterranean Diet (Med diet) through the validated Mediterranean Diet Literature-based adherence score (MEDI-Lite). The relationship between NL level and adherence to Med diet was assessed by linear regression analysis and computing correlations between NLit-IT and MEDI-Lite scores (Spearman's Rho). Additionally, we evaluated the correlation between NLit-IT score and the level of HL (Spearman's Rho). Internal consistency and reliability were measured by Cronbach's alpha and intraclass correlation coefficient (ICC) respectively. Internal consistency (ρT = 0.78; 95% CI, 0.69-0.84) and reliability (ICC = 0.68, 95% CI, 0.46-0.85) were confirmed. In addition, NLit-IT total score was correlated with MEDI-Lite score (Rho = 0.25; p-value = 0.031) and multivariate regression analysis confirmed that NL significantly contributed to MEDI-Lite score (R2 = 0.13; β = 0.13; p-value = 0.008). There was no significant association between the level of HL and NL. In conclusion, NLit-IT showed validity and reliability as a measure of NL for Italian people.
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Affiliation(s)
- Virginia Vettori
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Correspondence:
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Heather D. Gibbs
- Department of Dietetics and Nutrition, University of Kansas Medical Center, 3901 Rainbow Blvd/MS4013, Kansas City, KS 66160, USA;
| | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
- Unit of Clinical Nutrition, University Hospital of Careggi, 50134 Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Onlus IRCCS, 50134 Florence, Italy
| | - Vieri Lastrucci
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
- Global Health Center, Meyer University Hospital, 24 Gaetano Pieraccini Blvd, 50134 Florence, Italy
| | - Gino Sartor
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Ilaria Fulvi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Duccio Giorgetti
- School of Specialization in Hygiene and Preventive Medicine, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (G.S.); (D.G.)
| | - Giuseppe Cavallo
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, 48 Morgagni Blvd, 50134 Florence, Italy; (C.L.); (V.L.); (I.F.); (G.C.); (G.B.)
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